Impact of total body weight on acute kidney injury in patients with gram-negative bacteremia

2018 ◽  
Vol 11 (6) ◽  
pp. 651-654 ◽  
Author(s):  
Ronald G. Hall ◽  
Eunice Yoo ◽  
Andrew Faust ◽  
Terri Smith ◽  
Edward Goodman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Kidney Injury ◽  
Total Body Weight ◽  
Gram Negative ◽  
Gram Negative Bacteremia ◽  
Total Body

Vancomycin Removal during High-Volume Peritoneal Dialysis in Acute Kidney Injury Patients

2019 ◽  
Vol 39 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Daniela Ponce ◽  
Welder Zamoner ◽  
Fernanda Moreira Freitas ◽  
André Balbi ◽  
Linda Awdishu
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
High Volume ◽  
Total Body Weight ◽  
Empirical Treatment ◽  
Total Body

Studies on vancomycin pharmacokinetics in acute kidney injury (AKI) patients on high-volume peritoneal dialysis (HVPD) are lacking. We studied the pharmacokinetics of intravenous (IV) vancomycin in AKI patients treated by HVPD who received a prescribed single IV dose of vancomycin (15 - 20 mg/kg total body weight) to determine the extent of vancomycin removal and to establish vancomycin dosing guidelines for the empirical treatment of AKI patients receiving HVPD. The application of 18 mg/kg vancomycin every 48 - 72 hours in AKI patients undergoing HVPD was required to maintain therapeutic concentrations.

Impact of total body weight on 30-day mortality in patients with gram-negative bacteremia

2017 ◽  
Vol 15 (8) ◽  
pp. 797-803 ◽  
Author(s):  
Ronald G. Hall ◽  
Eunice D. Yoo ◽  
Andrew C. Faust ◽  
Terri Smith ◽  
Edward L. Goodman ◽  
...  
Keyword(s):  
Body Weight ◽  
Total Body Weight ◽  
Gram Negative ◽  
Gram Negative Bacteremia ◽  
Total Body

scholarly journals Impact of total body weight on rate of acute kidney injury in patients treated with piperacillin–tazobactam and vancomycin

2019 ◽  
Vol 76 (16) ◽  
pp. 1211-1217 ◽  
Author(s):  
W Cliff Rutter ◽  
Ronald G Hall ◽  
David S Burgess
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Combination Therapy ◽  
Kidney Injury ◽  
Total Body Weight ◽  
University Of Kentucky ◽  
Baseline Creatinine ◽  
Total Body ◽  
Using Data ◽  
The University

Abstract Purpose Results of a study to determine whether obesity is associated with acute kidney injury (AKI) among patients receiving combination therapy with piperacillin–tazobactam and vancomycin are reported. Methods A retrospective, single-center cohort study of patients who received combination therapy for at least 48 hours was conducted using data from the University of Kentucky Center for Clinical and Translational Science’s Enterprise Data Trust. Patients with chronic kidney disease, baseline creatinine clearance of less than 30 mL/min, cystic fibrosis, or missing height or weight information were excluded. Results A total of 8,125 patients were included in the cohort. Among the variables evaluated, total body weight of 91 kg or more was the variable most predictive of AKI. Patients with a weight of 91 kg or higher were more likely than lower-weight patients to have diabetes (39% versus 21%, p < 0.00001), hypertension (64% versus 47%, p < 0.00001), and heart failure (15% versus 13%, p = 0.007). The median daily vancomcyin dose was lower in patients with a weight of less than 91 kg (2,000 mg versus 3,000 mg, p < 0.00001); however, weight-based doses were lower in patients weighing 91 kg or more (25.5 mg/kg/day versus 27.9 mg/kg/day, p < 0.00001). AKI was more common in patients weighing 91 kg or more (24% versus 18%, p < 0.00001; adjusted odds ratio, 1.46 [95% confidence interval, 1.28–1.66]). Conclusion Increased total body weight increased the rate of AKI among patients concurrently treated with piperacillin–tazobactam and vancomycin independent of clinically important confounders, with an important breakpoint occurring at 91 kg.

scholarly journals Colistin-Induced Acute Kidney Injury and the Effect on Survival in Patients with Multidrug-Resistant Gram-Negative Infections: Significance of Drug Doses Adjusted to Ideal Body Weight

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Nittha Arrayasillapatorn ◽  
Palinee Promsen ◽  
Kittrawee Kritmetapak ◽  
Siriluck Anunnatsiri ◽  
Wijittra Chotmongkol ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Total Dose ◽  
Cox Regression ◽  
Kidney Injury ◽  
Ideal Body Weight ◽  
Multidrug Resistant ◽  
Gram Negative ◽  
Cox Regression Analysis ◽  
Ideal Body

Background. Colistin is a lifesaving treatment for multidrug-resistant Gram-negative bacterial (MDR-GNB) infections along with its well-known nephrotoxicity. The controversy of colistin-induced acute kidney injury (AKI) on mortality is noted. This study aimed to determine the risk factors and impact of AKI on the survival and significance of colistin dosage. Methods. A retrospective cohort study was performed in adult patients who received intravenous colistin for MDR-GNB treatment between June 2015 and June 2017. Factors influencing colistin-induced AKI and survival were evaluated by Cox regression analysis. Cut-off levels of the colistin dose per ideal body weight (IBW) that significantly affected clinical outcomes were assessed with linearity trends and receiver operating characteristic analyses. Results. AKI occurred in 68.5% of 412 enrolled patients with an incidence rate of 10.6 per 100 patients-days and a median time was 6 (3–13) days. Stages I–III of AKI were 38.3, 24.5, and 37.2%. Factors associated with colistin-induced AKI were advanced age, high serum bilirubin, AKI presented before colistin administration, increased daily colistin doses per IBW, and concomitant use of nephrotoxic drugs. Colistin-induced AKI was related to mortality (HR 1.74, 95% CI 1.06–2.86, p = 0.028 ). In the non-AKI before colistin usage subgroup, the total dose and total dose/IBW were >1,500–2,000 mg and 30–35 mg/kg to benefit mortality reduction but were <2,500–3,000 mg and 45–50 mg/kg for risk reduction of AKI. A daily colistin dose/IBW >4.5 mg/kg/day also increased the risk of AKI. In the AKI developed before colistin subgroup, the cut-off values of total colistin dose >1250–1350 mg and total dose/IBW >23.5–24 mg/kg demonstrated significant risks of AKI. Conclusion. The incidence of AKI after colistin administration was high and impacted mortality. Prevention and early correction of these related factors are mandatory. Careful use of colistin was also both beneficial in mortality and AKI reductions.

scholarly journals Lean body weight versus total body weight to calculate the iodinated contrast media volume in abdominal CT: a randomised controlled trial

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Moreno Zanardo ◽  
Fabio Martino Doniselli ◽  
Anastassia Esseridou ◽  
Massimiliano Agrò ◽  
Nicol Antonina Rita Panarisi ◽  
...  
Keyword(s):  
Body Weight ◽  
Contrast Media ◽  
Controlled Trial ◽  
Total Body Weight ◽  
Lean Body Weight ◽  
Iodinated Contrast Media ◽  
Abdominal Ct ◽  
Iodinated Contrast ◽  
Significant Difference ◽  
Total Body

Abstract Objectives Iodinated contrast media (ICM) could be more appropriately dosed on patient lean body weight (LBW) than on total body weight (TBW). Methods After Ethics Committee approval, trial registration NCT03384979, patients aged ≥ 18 years scheduled for multiphasic abdominal CT were randomised for ICM dose to LBW group (0.63 gI/kg of LBW) or TBW group (0.44 gI/kg of TBW). Abdominal 64-row CT was performed using 120 kVp, 100–200 mAs, rotation time 0.5 s, pitch 1, Iopamidol (370 mgI/mL), and flow rate 3 mL/s. Levene, Mann–Whitney U, and χ2 tests were used. The primary endpoint was liver contrast enhancement (LCE). Results Of 335 enrolled patients, 17 were screening failures; 44 dropped out after randomisation; 274 patients were analysed (133 LBW group, 141 TBW group). The median age of LBW group (66 years) was slightly lower than that of TBW group (70 years). Although the median ICM-injected volume was comparable between groups, its variability was larger in the former (interquartile range 27 mL versus 21 mL, p = 0.01). The same was for unenhanced liver density (IQR 10 versus 7 HU) (p = 0.02). Median LCE was 40 (35–46) HU in the LBW group and 40 (35–44) HU in the TBW group, without significant difference for median (p = 0.41) and variability (p = 0.23). Suboptimal LCE (< 40 HU) was found in 64/133 (48%) patients in the LBW group and 69/141 (49%) in the TBW group, but no examination needed repeating. Conclusions The calculation of the ICM volume to be administered for abdominal CT based on the LBW does not imply a more consistent LCE.

Increases in adipose and total body weight, but not in lean body mass, associated with subcutaneous administration of Sonic hedgehog-Ig fusion protein to mice

2002 ◽  
Vol 57 (3) ◽  
pp. 107-114 ◽  
Author(s):  
Pauline L. Martin ◽  
Joan Lane ◽  
Louise Pouliot ◽  
Malcolm Gains ◽  
Rudolph Stejskal ◽  
...  
Keyword(s):  
Body Weight ◽  
Fusion Protein ◽  
Lean Body Mass ◽  
Body Mass ◽  
Sonic Hedgehog ◽  
Subcutaneous Administration ◽  
Total Body Weight ◽  
Total Body

Effects of the teratogenic folic acid antagonist, 9-methyl pteroylglutamic acid, on hydroxyproline levels in fetal rat limbs

Development ◽  
1977 ◽  
Vol 41 (1) ◽  
pp. 289-294
Author(s):  
R. R. Schmidt ◽  
K. P. Chepenik ◽  
B. V. Paynton
Keyword(s):  
Body Weight ◽  
Folic Acid ◽  
Total Body Weight ◽  
Pregnant Rats ◽  
Skeletal Malformations ◽  
Fetal Rat ◽  
Pteroylglutamic Acid ◽  
Limb Malformations ◽  
Total Body ◽  
Rate Of Accumulation

Pregnant rats were subjected to either a folic-acid-deficient regimen that produces multiple congenital skeletal malformations, or a control folic-acid-supplemented regimen. Fetal limbs were extirpated on days 16 and 18 of gestation, pooled from each litter, homogenized, and aliquots set aside for hydroxyproline, protein and DNA determinations. We found that (1) the amount of protein recovered per treated limb was approximately half that of controls on both days, (2) the amount of protein recovered per treated or controlday-18 limb was twice that of a day-16 limb, (3) treated limbs constituted the same percentage of total body weight as in controls on day 16, but a smaller percentage than in controls on day 18, and (4) the concentration of hydroxyproline (μg/mg protein) was significantly less for treated limbs than for controls on day 18 of gestation. We noted also that: (1) lowest hydroxyproline concentrations were found in limbs from treated fetuses with gross limb malformations, (2) intermediate concentrations were found in limbs of treated fetuses not exhibiting gross limb malformations, and (3) highest concentrations were found in control limbs. We suggest that the treatment resulted in (1) a decreased rate of accumulation of protein in limbs prior to day 16, but not from day 16 to day 18, (2) a decreased rate of accumulation of some non-protein component(s) in treated limbs from day 16 to day 18, and (3) an altered collagen metabolism.

scholarly journals Growth and body weight of free-range reindeer in western Alaska

Rangifer ◽  
2000 ◽  
Vol 20 (2-3) ◽  
pp. 221 ◽  
Author(s):  
Greg L. Finstad ◽  
Alexander K. Prichard
Keyword(s):  
Body Weight ◽  
Growth Rates ◽  
Total Body Weight ◽  
Growth Patterns ◽  
Spatial And Temporal Variation ◽  
Adult Males ◽  
Body Weights ◽  
Total Body ◽  
Reproductive Females ◽  
Average Body

Total body weight of 9749 reindeer calves and 4798 adult reindeer were measured from 1984 to 1999 on the Seward Peninsula, western Alaska, USA. Growth rates of male and female calves, and annual growth patterns of adults were determined. Male calves grew faster than female calves. Reproductive females were lighter than non-reproductive females during summer but there was no effect of reproduction on average body weights the following winter. Adult males age 3-5 were heavier during summer than winter. Castrated males weighed the same as uncastrated males in summer, but were significantly heavier in winter, and did not display the large annual fluctuations in weight typical of reproductive males and females. Growth rates were higher and body weights greater in this herd than many other cir-cumpolar reindeer populations. We suggest these kinds of physiological indices should be used to monitor the possible effects of spatial and temporal variation in population density and to evaluate changes in herding practices.

scholarly journals SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Exercise Physiology ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Management Interventions ◽  
Co Morbidity ◽  
Total Body ◽  
Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

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